| NPI | 1821150624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 1105) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-641) |
| 225100000X Physical Therapist (Licence: AZ 3463) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |